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Haemorrhoids

DrGanesh DP 2
Dr Ganesh Ramalingam

Specialist in General Surgery

Condition

Haemorrhoids (Piles) In A Nutshell:

  • Haemorrhoids or piles are swollen veins found in the lower rectum. 
  • They are also differentiated by their location; internal haemorrhoids and external haemorrhoids.
  • While there are no known causes for haemorrhoids, certain factors such as straining during bowel movement, chronic constipation and prolonged periods of sitting on the towel may promote the development of haemorrhoids.
  • Haemorrhoids are usually diagnosed via a visual examination and confirmed through a digital rectal examination to detect signs of anomalies.

Serious cases of haemorrhoids are usually treated with a haemorrhoidectomy or a Rubber Band Ligation.

Table of Contents

Haemorrhoids (Piles) Surgery

What Are Haemorrhoids?

Haemorrhoids (also known as piles) are swollen veins found in the lower rectum. They are also differentiated by their location; internal haemorrhoids and external haemorrhoids.

Internal haemorrhoids are usually painless but tend to lead to bleeding, while external haemorrhoids may cause pain.

“Haemorrhoids are commonly known as piles. They are abnormally engorged and swollen blood vessels in the anus and lower rectum, causing discomfort, itchiness or pain. They can swell up with blood clots (thrombosed piles), causing severe pain. The more dangerous complication of piles is bleeding.”

Dr Ganesh Ramalingam

What Causes Haemorrhoids?

While there are no known causes for haemorrhoids, certain factors may promote the development of the condition. These plausible factors include:

  • Straining during bowel movement
  • Complications arising from chronic constipation
  • Prolonged periods of sitting, especially on the toilet
  • Family history of haemorrhoids

Recounting her experience managing haemorrhoids, Emma Hamilton shares her battle with the condition. When Emma finally decided to seek medical advice, she did not opt for any surgical options. She decided to follow her consultant’s advice by improving her lifestyle and avoid adding damage or stress to her sensitive bowel lining.

Eighteen months later, Emma was finally piles-free, and she was eating and drinking better while adopting a more active lifestyle.

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What Are The Risk Factors That Cause Haemorrhoids?

Certain factors increase the risk of developing haemorrhoids; they include:

  • Family history of haemorrhoids
  • Consistent heavy lifting
  • Being overweight or obese
  • Pregnancy
  • Prolonged standing
  • Consistent anal sexual intercourse
  • Prolonged diarrhoea

What Are The Symptoms Or Warning Signs If I Have Haemorrhoids?

The most common symptom of haemorrhoids is noticeable itching or irritation and pain around the anus. Apart from that, other symptoms may include:

  • An itchy or painful lump near the anus
  • Faecal leakage
  • Pain during bowel movements
  • Blood in stools after having a bowel movement

Although haemorrhoids can be painful, they are usually not a cause for concern and often go away on their own without treatment.

How Can Haemorrhoids Be Prevented?

Haemorrhoids can be prevented by taking extra care to reduce straining during a bowel movement. You may also consider increasing your water intake to loosen your stool.

Maintaining an active lifestyle and regular exercise can also help prevent constipation, reducing the strain from a bowel movement.

Avoid sitting for prolonged periods, especially when in the toilet and use the restroom immediately when you feel a bowel movement coming on.

In terms of dietary options, opt for high dietary fibre foods as it helps in creating bulk in the intestines, which aids in softening the stools, making bowel movement easier.

Speaking to CTV News, Katherine shares her experience in managing haemorrhoids. Katherine, who is in her mid-40s, has been suffering from both internal and external haemorrhoids for more than a decade.

Her first clue that something was wrong came when she noticed she was experiencing pain in her anus. Her doctor told her she had haemorrhoids and referred her to a specialist.

For Katherine, dealing with the condition was not as simple, as she is amongst the roughly eight per cent of people whose haemorrhoids recur, despite treatment.

“For patients with recurring haemorrhoids, they are usually recommended for surgery to remove the entire haemorrhoid, this procedure is called haemorrhoidectomy, and it is normally recommended for patients with a more serious case of haemorrhoids.”

Dr Ganesh Ramalingam

How Are Haemorrhoids Diagnosed?

Haemorrhoids can usually be diagnosed through a visual examination. To confirm the diagnosis, our doctor may recommend a digital rectal examination to investigate any abnormalities that they may observe within the anus.

During this examination, our doctor inserts a gloved and lubricated finger into your rectum. If they observe anything abnormal, our doctor may recommend an additional test known as a sigmoidoscopy.

A sigmoidoscopy involves our doctor using a small camera to diagnose an internal haemorrhoid. The small fibre-optic camera is known as a sigmoidoscope and fits into a small tube inserted into the rectum. This test allows our doctor to get a clearer view of the inside of your rectum to examine the haemorrhoid closer.

What Happens If I Leave My Haemorrhoids Untreated?

Untreated haemorrhoids can lead to complications and in some cases, they can lead to significant pain and even excessive bleeding in serious cases.

Some complications from haemorrhoids include:

  • Blood clots,
  • Skin tags,
  • Anemia, and
  • Strangulated haemorrhoids

A thrombosed haemorrhoid is a painful and unsettling occurrence. The blood clot may be purple or blue, making it easy to spot in the first place- but even if you do not notice this right away, it is usually accompanied by pain, especially when you are sitting down.

When the clot from a thrombosed haemorrhoid goes away, you might notice some loose skin on the region of the haemorrhoid. This can be uncomfortable and cause pain when rubbing or wiping over it because of how sensitive they are. 

Haemorrhoids can cause serious blood loss, which in turn could lead to anaemia. If you notice that the amount of blood that is observed during bowel movement is increasing, we will advise that you seek medical attention immediately.

The symptoms of a prolapsed haemorrhoid are often very painful and can be dangerous if not treated quickly. Prolonged pressure on the area may result in loss of blood supply, and in turn, lead to tissue death.

When Should I Worry About Haemorrhoids?

Most haemorrhoids do not require immediate medical treatment, and it is safe to wait a few days before seeing a doctor if your symptoms clear up at home. 

However, for haemorrhoids that are larger, a longer recovery period may be expected. If your condition does not improve after 4 days, you might want to consider seeing a doctor for professional advice.

What Are The Potential Complications Of Haemorrhoids?

Although complications from haemorrhoids are rare, they can include:

  • Blood clots in the swollen vein
  • Bleeding
  • Iron-deficiency anaemia caused by blood loss (uncommon)

How Are Haemorrhoids Treated?

Haemorrhoids Internal External

When treating haemorrhoids, our doctor may advise you on several courses of action depending on the severity of the condition.

To minimise pain from external haemorrhoid, soaking in a warm tub of water for at least 10 minutes a day may be a considered option. If the pain is unbearable, our doctor may recommend an over-the-counter medicated suppository, ointment, or cream to relieve the burning and itching.

Practising good hygiene by cleaning your anus with warm water during a shower or bath every day can improve the condition. When washing the anus, you do not have to use soap as some soaps can aggravate the haemorrhoids.

Should the initial course of management be unsuccessful, our doctor may recommend getting a rubber band ligation. This procedure involves cutting off the blood circulation of the haemorrhoid by placing a rubber band around it. The loss of blood circulation forces the haemorrhoid to shrink. As this procedure has its risks, it is recommended as an option only when performed by a medical professional.

For severe cases of haemorrhoids, our doctor may recommend a surgery called haemorrhoidectomy. A haemorrhoidectomy involves removing excess tissues causing the bleeding and protrusion, effectively eliminating the haemorrhoid(s).

What to expect:

  • Stop any prescription of aspirin or other blood thinning medications with a doctor’s advice.
  • All regular medications will be stopped unless absolutely necessary under a doctor’s supervision.
  • Do not eat or drink anything 8 hours before your surgery.
  • You may need a colonoscopy to ensure there are no other problems with your colon before the piles surgery.
  • This procedure is usually a day surgery. However, you may decide to stay in the hospital for a day or two.
  • There are many methods to treat the piles surgically.
  • Your surgeon will advise you on the specific details.
  • Resume your normal diet when you are fully awake from surgery.
  • Increase your fibre intake and drink lots of water. Avoid foods that will cause constipation/diarrhoea.

It is essential to recognise that haemorrhoids and their conditions may affect a person’s lifestyle. Many people are too embarrassed to see the doctor until the pain and discomfort become unbearable or bleeding occurs. Seeking medical advice early may help to manage the conditions better before it worsens.

While speaking to E! on a podcast, Nikki Bella shares her own experience managing pregnancy haemorrhoid. Nikki developed a pregnancy haemorrhoid which she felt was a “particularly aggravating pregnancy side effect”.

Her following weeks of treatment involved sitting every night in a warm bath to alleviate the pain.

Should I Pop A Haemorrhoid On My Own?

While haemorrhoids can be very uncomfortable, you should not try to pop them on your own. Without proper management, a popped haemorrhoid can lead to more pain, complications, and discomfort. If not managed well, it can also leave you at risk of developing a potentially severe infection or damage delicate skin tissue around the anal region.

Moreover, as they are located in a region that is difficult to be seen, attempting to pop a haemorrhoid yourself can make it easy to accidentally injure the delicate tissue surrounding your anal area.

While managing your haemorrhoid, it is essential not to attempt to self-diagnose. A delay in the proper diagnosis may leave you unaware of other more severe conditions such as anal cancer.

Additionally, your anal area is exposed to bacteria from both bowel movements and the skin. An open wound in this area, including the type that would result from popping a haemorrhoid, is very vulnerable to infection.

Frequently Asked Questions

Haemorrhoids can occur at any age but they are most common among adults over the age of 50 as tissues weaken. They also tend to occur in pregnant women as the extra baby weight can put pressure on the anal region.

Smaller haemorrhoids may go away after a few days. However, larger haemorrhoids that are swollen and causing a lot of discomfort will likely require medical treatment. 

You should consume fibre-rich foods such as whole-grain bread, oatmeal and nuts to ensure softer stool that does not aggravate the haemorrhoid. Refrain from eating fatty and processed food that can cause constipation. 

No, haemorrhoids are not an indicator of cancer. However, haemorrhoids can cause blood in the stool so it is best to check with your medical practitioner to rule out colorectal or anal cancer.

When a haemorrhoid becomes full of blood, it is possible for it to burst. If the bleeding lasts for more than 10 minutes, you should visit your medical practitioner to get it checked.

Why Choose Us For Your Haemorrhoid (Piles) Surgery In Singapore?

Dr Ganesh at G & L Surgical Clinic strives to prioritise his patients’ recovery and comfort. Having had adequate experience in performing haemorrhoid (piles) surgeries for numerous patients for many years in Singapore.

Furthermore, the staff at G & L Surgical Clinic have been thoroughly and adequately trained to make your experience a comfortable and hassle-free one. Whether you intend to undergo our haemorrhoid (piles) surgeries or other medical services in Singapore, you can rest assured that you will be properly and sufficiently cared for by trained professionals.

Organise a consultation with our surgeons for further assistance on haemorrhoid (piles) surgeries in Singapore.